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The Hedgehog Review: Vol. 16 No. 2 (Summer 2014)

Mind, Modernity, Madness: The Impact of Culture on Human Experience

Liah Greenfeld

Cambridge, MA: Harvard University Press, 2013.

Reprinted from The Hedgehog Review 16.2 (Summer 2014). This essay may not be resold, reprinted, or redistributed for compensation of any kind without prior written permission. Please contact The Hedgehog Review for further details.

The Hedgehog Review: Summer 2014

Liah Greenfeld, a professor of sociology at Boston University, describes Mind, Modernity, Madness as the product of “a new—radically different—approach that has never been tried.” At 688 pages, it is a long book that ranges in its “interdisciplinarity” from the clinical epidemiology of bipolar depression to the historiography of romantic love in Shakespeare. But it has a clear, bold thesis: that the advent of madness is connected, as both cause and effect, to the rise of nations and nationalism.

More specifically, Greenfeld contends, the historical conditions that gave rise to the nation—a community of equals; a measure of individual autonomy, liberty, and mobility; and a declining acknowledgment of divine authority—make madness not only possible but inevitable. As the value of human life grows and becomes of paramount concern, self-invention and romantic love become popular ideals, and even common people are driven by ambition, aspiration, and the pursuit of happiness. “Modern culture,” Greenfeld writes, “leaves us free to decide what to be and to make ourselves. It is this cultural laxity that is anomie—the inability of a culture to provide the individuals within it with consistent guidance.”

The author’s evidence is historical and biographical. Her conceptual framework is sociological, inspired by Émile Durkheim’s 1897 book Suicide. Indeed, Greenfeld’s vision of modernity restates and broadens Durkheim’s view that social disintegration produces the anomie and alienation that can lead to self-destructive behavior and acts, including the taking of one’s own life. While Durkheim adduced higher rates of suicide in the anomic nations of later-nineteenth-century Protestant Europe, Greenfeld focuses on the worldwide epidemiology of schizophrenia, bipolar disorder, and major depression, which she regards as an overwhelming threat to Western civilization.

Greenfeld rejects the “constructivist” approach that she believes is prevalent “among Western social scientists—anthropologists, sociologists, and historians studying psychiatry—who conclude that madness is largely an invented problem… analogous to the equally false ‘social constructions’ of witchcraft and possession of other cultures, but dressed in a scientific garb and unjustifiably enjoying the authority of science in ours.” She derides the “poetic” excesses of Michel Foucault’s Madness and Civilization, but ignores constructivist conceptualizations of greater consequence, notably “idioms of distress” and “bio-looping,” which circulate freely within clinical psychiatry and can be found in the Diagnostic and Statistical Manual on Mental Disorders in appendixes on somatization syndromes and cultural psychiatry.

When Greenfeld accuses anthropologists of creating “false social constructions” of witchcraft and possession and repeating this effect on Western madness, she means that anthropologists have misconstrued how culture, mind, consciousness, brain, and madness are connected. Culture, in her view, is an ideational, symbolic, non-material phenomenon. Human consciousness is an emergent phenomenon, “logically consistent with the biological and physical laws but autonomous,” and irreducible to organic reality. The human mind comprises or contains a form of collective consciousness she calls “culture in the brain.”

These conceptions, Greenfeld says, run counter to the dominant “dual mind/body view of reality,” which attributes causal primacy to the “material” (the central nervous system) over the “spiritual” (consciousness, mind, culture). Culture and consciousness, in this paradigm, are epiphenomena of the material world: causation proceeds from brain to mind via identifiable mechanisms. In other words, culture can disguise the material nature of madness but cannot interfere with it. Constructionists are said to share these conventions.

Greenfeld emphatically rejects the dualist paradigm, contending that culture can and does cause biologically real (material) diseases, including madness. She believes that her thesis, being both counterintuitive and empirically proven, has revolutionary implications for how we understand and address the increasing prevalence of madness in our current era and culture. Furthermore, she believes that her thesis enables her to advance additional, counterintuitive claims concerning the historical origins and epidemiology of madness.

Yet it is unclear to me whether Greenfeld’s thesis is truly revolutionary. The difficulty comes in her proposal that culture causes biologically real diseases. There are two ways to interpret this claim. She could mean that “culture in the brain” is a source of distressful dilemmas, contradictions, and emotions that precipitate chains of physiological, molecular, neurological, and anatomical effects; that these changes in turn undermine the homeostasis underpinning normal functioning; and that, as a result, a pathogenic loop is created and sustained. This interpretation seems consistent with the process Greenfeld is proposing, and it is consistent with what she says about clinical psychiatry and research. This is a credible thesis, but it is far from being counterintuitive or revolutionary. Indeed, it is the prevailing approach among anthropologists and other social scientists interested in mind, brain, and psychopathology.

But Greenfeld may have something far more original in mind: “So long as there remains the unresolved philosophical mind-body problem, no significant advance in human neuroscience and, therefore, psychiatry would be possible.… The first order of the business is, therefore, to escape the mind-body quagmire.” If, in this book, she has found a way out of this 400-year-old problem, however, it is not at all obvious to this reader what it is.

Such matters occupy only two chapters. The remaining 500 pages are devoted to “madness.” According to Greenfeld, the term was coined in England in the early modern period (fifteenth and sixteenth centuries), then spread to France and Germany. Between 1880 and 1900, “madness” bracketed the maladies we know today as schizophrenia and bipolar disorder. (In psychiatry, there is currently renewed interest in reconnecting the two disorders on a single diagnostic spectrum.) The author further describes the history of the term in separate chapters on Europe and America.

In a brief but provocative epilogue, Greenfeld argues that culture is simultaneously a source of madness and a source of self-medication that attenuates the severity of madness. As pathogenic forces strengthen, she writes, self-medication grows equally more desperate and socially disruptive in an era of globalization:

“Paradoxically, the rate of severe (clinical) mental disturbance should, in general, be proportional to the possibility of engaging in ideologically motivated collective activism; that is, the rate of disturbance should necessarily be highest in individualistic nations, and higher in collectivistic civic nations than in ones organized on the basis of ethnicity. The most aggressive and xenophobic strains of nationalism—the worst kind for international comity—would be the best for the mental health of individual citizens in states where such virulence held sway.”

Mind, Modernity, Madness is the final volume in Greenfeld’s trilogy on nationalism. It provides readers with a provocative commentary on the sociocultural origins and psychopathological consequences of modernity. And it is a splendid antidote to the reckless application of the term “madness,” by both pundits and politicians, to the policies and persons of America's political opponents and the excesses of their nationalisms.

Allan Young, professor of anthropology at McGill University and author of The Harmony of Illusions: Inventing Posttraumatic Stress Disorder (1995), is completing a book on the social brain, psychopathology, and myths of empathy.

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Published three times a year by the Institute for Advanced Studies in Culture, The Hedgehog Review offers critical reflections on contemporary culture—how we shape it, and how it shapes us.